title: Esophageal perforation, the most feared complication of TEE: early recognition by multimodality imaging.
abstract: Esophageal perforation is the most feared complication of transesophageal echocardiography (TEE), although the overall risk is extremely low. We report a case of esophageal perforation in a 77-year-old woman who had no apparent contraindications to TEE. Chronic steroid therapy for symptoms of asthma as well as osteophytic changes of the cervical vertebrae contributed to her increased risk of perforation. Unlike in prior reports, the perforation in this case was fortuitously recognized rapidly due to ingestion of a carbonated beverage for evaluation of a hiatal hernia suspected during a subsequent transthoracic echocardiogram performed because of inadequate TEE images after a difficult intubation. The incidence of esophageal perforation in our series (1 in 5,000 TEEs, 0.02%) is similar to that reported in the literature. Early recognition and prompt surgical repair of the esophageal perforation led to favorable outcome in our patient.
authors.affiliation: Department of Medicine Department of Radiology Department of Surgery, New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Nisha
authors.initials: N
authors.lastname: Bavalia
authors.forename: Ather
authors.initials: A
authors.lastname: Anis
authors.forename: Michael
authors.initials: M
authors.lastname: Benz
authors.forename: Pierre
authors.initials: P
authors.lastname: Maldjian
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Bolanowski
authors.forename: Muhamed
authors.initials: M
authors.lastname: Saric
mesh_terms: D000368:Aged; D042241:Early Diagnosis; D017548:Echocardiography, Transesophageal / Q000009:adverse effects*; D004939:Esophageal Perforation / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D013382:Subtraction Technique